NPIMap

Organization Active NPI

Jackson Gastroenterology Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Jackson, MI
National Provider Identifier
1265618904
Registry record updated Oct 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
JACKSON GASTROENTEROLOGY CENTER, LLC
Practice address
4400 Ann Arbor Road
Jackson, MI 49202
Phone
(517) 990-0602
NPI assigned
Jan 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Rodney Lunn
Title
Member
Phone
(615) 425-0818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X MI Primary

Addresses

Primary practice location

4400 Ann Arbor Road
Jackson, MI 49202

Mailing address

4400 Ann Arbor Road
Jackson, MI 49202
Phone (517) 990-0602

Other identifiers 1

IdentifierTypeStateIssuer
38-6814OtherMIFACILITY NUMBER

Other names 1

  • East Jackson Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224460800000",
    "number": "1265618904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 ANN ARBOR ROAD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "49202",
            "telephone_number": "517-990-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 ANN ARBOR ROAD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "49202",
            "telephone_number": "517-990-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON GASTROENTEROLOGY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-10-20",
        "status": "A",
        "authorized_official_last_name": "LUNN",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "615-425-0818",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY NUMBER",
            "identifier": "38-6814",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Jackson Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.